实验室检查在多发性骨髓瘤单克隆免疫球蛋白中的诊断价值  

Diagnostic value of laboratory tests for monoclonal immunoglobulin in multiple myeloma

作　　者：李玉珠[1] 史敦云[1] 黄德善 张琼丽[1] 李明[1] 杜新[1] 

机构地区：[1]深圳市第二人民医院血液病研究所,518035

出　　处：《中国药物与临床》2016年第6期798-801,共4页Chinese Remedies & Clinics

摘　　要：目的探讨多发性骨髓瘤单克隆免疫球蛋白(M蛋白)的临床诊断价值。方法采用免疫固定电泳(IFE)、血清蛋白电泳(SPE)及免疫球蛋白定量(Ig)技术检测105例多发性骨髓瘤患者的血清和尿液,其中10例MM患者进行自体骨髓移植,对其血清M蛋白的表达进行跟踪检测。结果 105例多发性骨髓瘤患者血清免疫固定电泳M蛋白105例阳性,阳性率为100.0%;尿本周氏蛋白阳性76例,阳性率为72.4%(76/105)。25例血清M蛋白为轻链型患者尿本周蛋白阳性率为92.0%(23/25);血清蛋白电泳78例出现M带,检出率为74.3%(78/105);免疫球蛋白定量68例显著升高,阳性率为64.8%(68/105)。结论免疫固定电泳检测M蛋白对诊断MM具有高度的敏感性和特异性,是M蛋白定性和分型的重要指标;血清蛋白电泳和免疫球蛋白定量检测M蛋白可早期筛查MM,减少误诊或漏诊;三项指标联合检测M蛋白对MM的诊断、病情监测、疗效评估及预后判断提供重要依据。Objective To evaluate the value of laboratory tests for monoclonal immunoglobulin （M protein） in clinical diagnosis of multiple myeloma （MM）. Methods Immunofixation electrophoresis （IFE）, serum protein elec-trophoresis （SPE） and immunoglobulin quantification （IQ） were used to evaluate the M protein in the serum and urine samples from 105 MM patients, including 10 MM patients undergoing autologous bone marrow transplantation. The expression of serum M protein was followed up. Results Of 105 MM patients, IFE detected serum M protein in 100%（105/105）, and urine Bence-Jones protein in 72.4%（76/105）. Of 25 MM patients with serum light-chain M pro-tein, 92.0% （23/25） tested positive for urine Bence-Jones protein. SPE showed M band in 78 cases, with a detection rate of 74.3%（78/105）. Immunoglobulin quantification indicated significantly higher level of M protein in 68 MM pa-tients, with the positive rate being 64.8%（68/105）. Conclusion IFE test for M protein is highly sensitive and specif-ic for the diagnosis of MM, and is important for characterization and classification of M proteins; SPE and IQ tests for M protein may be used for early screening of MM, and may reduce misdiagnosis or negligence of MM. When used in combination, the three tests for M protein may offer important evidence for the diagnosis, monitoring, outcome evalua-tion and prognosis of MM.

关 键 词：多发性骨髓瘤 诊断 免疫球蛋白M 

分 类 号：R733.3[医药卫生—肿瘤]